Provider Demographics
NPI:1134320534
Name:PINTO, PHILLIP VINCENT (DC)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:VINCENT
Last Name:PINTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 BANSON ST
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510
Mailing Address - Country:US
Mailing Address - Phone:661-269-2819
Mailing Address - Fax:661-269-2819
Practice Address - Street 1:3630 BANSON ST
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:CA
Practice Address - Zip Code:93510
Practice Address - Country:US
Practice Address - Phone:661-269-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11498 DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor